Med Surg- Respiratory

Question 1

Presenting to a 3rd gr class how to prevent transmission of the cold virus. Which information should the nurse discuss?

Accepted Answer

Include a demonstration of how to wash hands correctly

Question 2

Pt w/ pleural effusion- dec breath sounds on the RL lobe and dyspnea. Which intervention should the nurse anticipate?

Accepted Answer

Thoracentesis at the bedside

Question 3

A nurse is caring for a patient with atelectasis. What intervention would be appropriate?

Accepted Answer

Encourage the use of incentive spirometry

Question 4

Which is a late sign of hypoxia?

Accepted Answer

Cyanosis

Question 5

The change of shift report has just been completed (med-surg). Which pt will the oncoming nurse plan to assess first?

Accepted Answer

Pt w/ CF, elevated temp and RR of 38 breaths/min

Question 6

The day shift charge nurse on a medical unit is making rounds after report. Which patient should be seen first?

Accepted Answer

45 yr old w/ pneumonia who has pulse ox of 92%

Question 7

The influenza vaccine is in short supply. Which group of clients would the public health nurse consider priority?

Accepted Answer

Elderly and chronically ill patients

Question 8

Pt w/ TB is on isoniazid and rifampin. Which lab should the nurse monitor regularly?

Accepted Answer

Liver function tests

Question 9

When caring for a pt w/ aspiration pneumonia, pt dyspneic, begins to cough & turn blue. Which nursing intervention 1st

Accepted Answer

Turn the client to the side

Question 10

In a patient suspected with pulmonary embolism, which diagnostic test should the nurse anticipate?

Accepted Answer

CT pulmonary angiography

Question 11

Pt (COPD) did not get flu or pneumonia vacc, Which vital sign change would be most important to report to nurse?

Accepted Answer

Oral temp 101.2°F

Question 12

Which instruction is important for a ptaient receiving a TB skin test?

Accepted Answer

Return in 48-72 hours for reading

Question 13

Possibly been exposed to pt w/ active TB. Which indicates the need for radiological evaluation instead of skin test?

Accepted Answer

The pt's previous skin test was read as positive

Question 14

Pt in ER w/ sudden onset of sharp, stabbing CP that worsens w/ deep breathing. What condition should the nurse suspect?

Accepted Answer

Pleurisy

Question 15

Pt w/ percutaneous gastrostomy (PEG) feeding tube. Which interventions would the nurse include in the plan of care?

Accepted Answer

Elevate the head of the bed after feeding the client

Question 16

Discharge teaching for a patient who had a spontaneous pneumothorax. Which statement by the pt indicates understanding?

Accepted Answer

"I should avoid flying for at least a month"

Question 17

The nurse is assessing a 79 yr old dx w/ pneumonia. Which signs and symptoms would the nurse expect to find?

Accepted Answer

Confusion and lethargy

Question 18

When caring for the pt returning fr thoracotomy & chest tube, the pt reports severe pain. What does the nurse do first?

Accepted Answer

assess location and quality of pain

Question 19

Pt w/ CF has thick secretions and frequent atelectasis, Which nursing intervention is best to mobilize secretions?

Accepted Answer

Administer dornase alfa (Pulmozyme) inhalation

Question 20

Pt has been diagnosed with pleural effusion. Which symptom is most characteristic of this condition?

Accepted Answer

Dyspnea

Question 21

Pt w/ acute exacerbation of asthma- increased SOB w/ inspiratory & expiratory wheezes. Which med will you admin 1st

Accepted Answer

Albuterol-2 inhalations

Question 22

Admit to ICU after LL lobectomy via video-assis thorascopic surgery. Which prescriptions will the nurse implement 1st?

Accepted Answer

Titrate O2 flow rate to keep saturation at or greater than 93%

Question 23

Pt w/ asthma reports nighttime coughing & wheezing- which long-term med should the nurse reinforce teaching about?

Accepted Answer

montelukast (singulair) daily in the evening

Question 24

Which finding would be of most concern to a nurse assessing a patient 24 hours after a lobectomy?

Accepted Answer

A decrease in breath sounds on the affected side

Question 25

Pt has had a lobectomy & chest tube 8 hrs ago. When performing initial assessment, which requires immediate follow up?

Accepted Answer

2oo mL red drainage from the chest tube over 2 hours

Question 26

Eval & assessing pt w/ chronic emphysema. Pt is receiving O2 at 5 L/min by nasal cannula. Which is an immediate concern?

Accepted Answer

Respiratory rate of 8 breaths/min

Question 27

What recommendation should a nurse give to a patient with COPD to improve their nutritional status?

Accepted Answer

"Eat small, frequent meals throughout the day"

Question 28

Pt w/ acute exacerbation of COPD: anxious, resettles, confused. pH 7.30, PaCO2 56, PaO2 78. Which intervention first?

Accepted Answer

Apply noninvasive positive-pressure ventilation (BiPAP)

Question 29

Caring for patient diagnosed with pneumonia, Which info should the nurse include in the teaching plan? (SATA)

Accepted Answer

Monitor the pt's pulse ox reading every 4 hours, Place pt on O2 by nasal cannula, plan for periods of rest during ADLs

Question 30

What should the nurse monitor in a patient diagnosed with pulmonary edema?

Accepted Answer

Pink frothy sputum

Question 31

Teaching a pt about proper use of a MDI. Which statement by the patient indicates a need for further teaching?

Accepted Answer

"I'll breathe in quickly when activating the inhaler"

Question 32

The pt says, "I hate this stupid COPD." What is the best response by the nurse?

Accepted Answer

"You sound fed up with managing your illness"

Question 33

Pt is scheduled for a thoracentesis. In which position should the nurse place the patient?

Accepted Answer

Sitting upright, leaning forward

Question 34

A child with croup arrives with a barking cough & inspiratory stridor at rest. Which intervention should you prepare?

Accepted Answer

Aerosolized racemic epinephrine

Question 35

Which action is most crucial for a nurse to take when suctioning a tracheostomy?

Accepted Answer

Apply suction only when withdrawing the catheter

Question 36

Pt w/ acute bronchitis has a productive cough & low-grade fever. Which instruction should the nurse emphasize?

Accepted Answer

Increase oral fluid intake

Question 37

Which instruction should a nurse emphasize to a patient who recently had a tonsillectomy?

Accepted Answer

"Avoid drinking through straws"

Question 38

Assessing a pt w/ a hx of smoking, nurse hears a low-pitched, rumbling sound on expiration. How should you document?

Accepted Answer

Rhonchi

Question 39

Pt w/ influenza A is being discharged from ED w/ rx for antibiotics. Which statement by the pt indicates understanding?

Accepted Answer

"The antibiotics will help prevent me from developing a bacteria pneumonia"

Question 40

Pt w/ hx of COPD has an O2 saturation of 88%. Which intervention should the nurse prioritize?

Accepted Answer

Encourage the patient to use a pursed-lip breathing technique

Question 41

Pt dx w/ community-acquired pneumonia admit to med unit. Which nursing intervention has the highest priority?

Accepted Answer

Obtain a sputum specimen for culture and sensitivity

Question 42

Pt smokes 2 packs/day, barrel chest, dyspnea, & decreased tactile fremitus. Which condition does the nurse suspect?

Accepted Answer

Emphysema

Question 43

A nurse should recognize which of the following as a risk factor for lung cancer?

Accepted Answer

Exposure to radon

Question 44

The nurse is planning care of a pt dx w/ pneumonia and writes a problem of "impaired gas exchange" Expected outcome?

Accepted Answer

Alert and oriented to person, place, time, and event

Question 45

For which patient would the nurse anticipate administering a bronchodilator?

Accepted Answer

A pt with asthma

Question 46

Pt w/ TB is being discharged. Which statement indicates an understanding of instructions?

Accepted Answer

"I must stay on the medication for months if I am to get well"

Question 47

Pt admitted w/ status asthmaticus. Nurse finds sudden absence of wheezing in lung fields & sets which as the priority?

Accepted Answer

Activation of the rapid response team to secure an airway

Question 48

When caring for a pt w/ chronic bronchitis, which of these interventions will assist the pt in mobilizing secretions?

Accepted Answer

Consume at least 2 L of fluids daily

Question 49

Pt w/ acute PE has pink, frothy sputum, crackles, severe dyspnea. Which prescribed intervention should you question?

Accepted Answer

IV nitroprusside infusion

Med Surg- Respiratory

Questions 49

Med Surg- Respiratory

Questions 49